获得性胆脂瘤术后听力失败时修订鼓室成形术和植入式听力设备的候选者
Candidates for Revision Tympanoplasty and Implantable Hearing Devices in Cases of Postoperative Hearing Failure in Cholesteatoma.
文献信息
| PMID | 42732641 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yuko Kondo |
| 作者单位 | Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan. |
| 期刊 | The journal of international advanced otology |
| SCI 分区 | Q3 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 评估因获得性胆脂瘤接受鼓室成形术患者的术后听力结果，并确定适合接受修订手术或植入式听力设备的候选者。
方法： 这项回顾性研究分析了2009年至2015年间因获得性胆脂瘤接受初次鼓室成形术的177例患者。根据气骨导差（ABG）对术后听力结果进行分类，≤15 dB定义为成功。根据镫骨完整、CT显示中鼓室含气以及无鼓膜粘连来确定修订鼓室成形术的候选者。按照日本耳科学会（JOS）指南评估人工耳蜗（CI）、骨锚式助听器（Baha®）和Vibrant Soundbridge（VSB）的资格。
结果： 在177例患者中，98例（55.3%）听力结果不成功。其中，46例（46.9%）是修订鼓室成形术的候选者，37例（37.7%）是植入式听力设备的候选者（3例适合CI，13例适合Baha®，27例适合VSB），部分存在重叠。总体而言，98例患者中有71例（72.4%）符合修订手术或听力设备植入的条件。
结论： 超过半数因获得性胆脂瘤接受鼓室成形术的患者术后听力欠佳；然而，许多患者仍可成为进一步干预的候选者，这凸显了结构化术后再评估、个体化听觉康复以及医生与机构之间协作照护的重要性。
英文摘要
BACKGROUND: To evaluate postoperative hearing outcomes in patients undergoing tympanoplasty for acquired cholesteatoma and to identify candidates suitable for revision surgery or implantable hearing devices.
METHODS: This retrospective study analyzed 177 patients who underwent primary tympanoplasty for acquired cholesteatoma between 2009 and 2015. Postoperative hearing outcomes were classified based on the air-bone gap (ABG), with ≤15 dB defined as successful. Candidates for revision tympanoplasty were identified according to the presence of an intact stapes, aerated mesotympanum on CT, and absence of tympanic membrane adhesion. Eligibility for cochlear implants (CIs), bone-anchored hearing aids (Baha®), and Vibrant Soundbridge (VSB) was assessed following Japan Otological Society (JOS) guidelines.
RESULTS: Of 177 patients, 98 (55.3%) had unsuccessful hearing outcomes. Among these, 46 (46.9%) were candidates for revision tympanoplasty and 37 (37.7%) for implantable hearing devices (3 for CI, 13 for Baha®, and 27 for VSB), with partial overlap. Overall, 71 of the 98 patients (72.4%) were eligible for either revision surgery or hearing device implantation.
CONCLUSION: More than half of the patients undergoing tympanoplasty for acquired cholesteatoma had suboptimal postoperative hearing; however, many patients remained candidates for additional interventions, highlighting the importance of structured postoperative reassessment, individualized auditory rehabilitation, and collaborative care between physicians and institutions.